The HANDLS study is a prospective, epidemiologic, longitudinal study of a baseline representative sample of African Americans and whites between 30-64 years old recruited as a fixed cohort of participants by household screenings from an area probability sample of twelve census segments in Baltimore City. The HANDLS design is an area probability sample of Baltimore based on the 2000 Census. Using this methodology, working with survey statisticians we chose 12 neighborhoods to meet race by SES by age distribution because they were likely to yield representative distributions of Baltimore City with sufficient individuals to fill the sampling design based. Within the 12 neighborhoods, housing units were selected with a known non-zero chance of selection. The addresses were screened for individuals who meet the age-gender-race-poverty sample size, and those were chosen to be included in the sample using a probability sampling method. From these probabilities, we can compute weights to adjust for unequal probabilities of selection. These weights will be needed to compute estimates that combine subjects across any of the age-gender-race-poverty group. The poverty status delimiter is 125% poverty based on 125% of the 2004 Health and Human Services Poverty Guidelines. The initial examination and recruitment phase took approximately 4 years to complete. The study data was collected in two parts. The first part consisted of an in-home interview that includes questionnaires about the participants health status, health service utilization, psychosocial factors, nutrition, neighborhood characteristics, and demographics. The second part was collected on the medical research vehicles and includes medical history and physical examination, dietary recall, cognitive evaluation, psychophysiology assessments including heart rate variability, arterial thickness, carotid ultrasonography, assessments of muscle strength and bone density, and laboratory measurements (blood chemistries, hematology, biomarkers of oxidative stress and biomaterials for genetic studies). Using our mobile medical research vehicles, we visit each census tract for 4 months and we will re-visit every census tract in a 3.5-year cycle. HANDLS completed its baseline examination wave on March 30, 2009 with a final total accrural of 3724 participants. The cohort is comprised of 2201 African American (59%) and 1523 Whites (41%). Approximately 41% of the cohort reported a household income below the 125% poverty status delimiter. Of those below the 125% poverty delimiter, 13 % were white and 28% African American. Of those above the 125% poverty delimiter, 28% were white and 31% African American. The mean age of the sample was 47.7 years. There were no significant age differences associated with sex or race. Participants below the 125% poverty delimiter were slightly younger than those above the delimiter.Thus far our Interim Re-contact Study (Wave 2) which reaches out to participants approximately 18 months after initial baseline visit completion has been able to re-contact approximately 74% of participants initially seen between 2004 and 2006. This has laid the ground work for the beginning of the next full examination wave (Wave 3) which began July 8, 2009 with a dress rehearsal in the South Baltimore neighborhood. We have already begun assembling collaborations to pursue important clinical and psychosocial research directions utilizing the data we are collecting from this unique cohort. These are projects that span a broad range of area of clinical medicine and include a large number of established minority investigators as well as students and physicians in training. The Wave 3 protocol in keeping with the longitudinal study design maintains many of the same study domains as the baseline wave 1 examination including: cognition, cardiovascular disease, nutrition, physical performance, psychology, health services, genomics (genetics and epigenetics), and molecular biomarkers of disease. This protocol also includes new ares of study particularly focused on critical health disparities including, renal function, neuroanatomy, financial and health literacy. Covariates: Other variables include nutrition, environment and neighborhood effects, genetic make-up, family history, activity level, access to health care, and prevalent medical, dental, psychiatric conditions, oxidative stress, and DNA repair capacity which may modulate the effects of SES and race on cardiovascular, musculoskeletal, cognitive, and autonomic functioning.